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目的家族性结肠息肉病(FPC)病人一般年轻,术后须保持正常的大、小便功能与性功能,才能有高质量的生存,这就依赖于全直肠肌鞘的保留。在本文中,我们将探讨FPC病人保留全直肠肌鞘的意义与旋转剥离直肠粘膜的技巧。方法复习我们所作过的“旋转剥离直肠粘膜”并保留全直肠肌鞘的手术,探讨这类改进手术在治疗FPC病人中的效果,特别是提高术后年轻病人的生活质量方面所起的重要作用。结果完整剥离直肠粘膜,直肠肌鞘内不遗留残膜,不会产生“粘膜分泌”、造成的近期感染以致手术失败,也不会在远期造成直肠息肉复发及癌变。结论保留全直肠肌鞘,就保存了储便排便的肌性器官,同时也保存了附着的骶神经丛,使术后大便正常,小便及性动能亦未损伤。
Purpose Focal colon polyposis (FPC) patients are generally young, after surgery to maintain normal large, urinary function and sexual function, in order to have a high quality of life, which relies on the preservation of the whole rectus sheath. In this article, we will explore the implications of FPC preservation of the rectal sheath and the technique of rotating the rectal mucosa. METHODS: We review the “spin-off of the rectal mucosa” and the preservation of the whole rectus muscoid sheath and discuss the important role of such modified surgery in the treatment of FPC patients, especially in improving the quality of life of young patients after surgery . Results Complete dissection of the rectal mucosa, rectal muscle and sheath left without residual membrane, will not produce “mucosal secretion”, resulting in the recent infection that surgery failed, it will not cause recurrence of rectal polyps and cancer in the long term. Conclusion Retention of the whole rectus muscular sheath preserves bowel muscles and stores sacral plexuses attached to the sacral plexus. The postoperative stool is normal, and urination and kinetic energy are also not impaired.